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Men’s Use and Perceptions of Commercial Lubricants: Prevalence and Characteristics in a Nationally Representative Sample of American Adults Michael Reece, PhD, MPH,* Debby Herbenick, PhD, MPH,* Vanessa Schick, PhD,† Stephanie A. Sanders, PhD,‡§ and J. Dennis Fortenberry, MD, MS¶ *Center for Sexual Health Promotion, Indiana University, Bloomington, IN, USA; †University of Texas, Houston, TX, USA; ‡ The Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA; § Department of Gender Studies, Indiana University, Bloomington, IN, USA; ¶Division of Adolescent Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA DOI: 10.1111/jsm.12480
ABSTRACT
Introduction. Most research on men’s use of commercial lubricants during sexual activities is in the context of condom use and often specifically among men who have sex with men. Less is known about men’s use of lubricants associated with a broader range of sexual experiences. Aims. The aims of this study are to document the prevalence of commercial lubricant use among adult U.S. men (age 18+), to document men’s use of lubricants across solo and partnered sexual behaviors, and to assess men’s perceptions of the contributions lubricants have to the sexual experience. Methods. Data are from the 2012 National Survey of Sexual Health and Behavior, which involved the administration of an online questionnaire to a nationally representative probability sample of U.S. adults ages 18 and older. Main Outcome Measures. Sociodemographic characteristics, recent and lifetime commercial lubricant use, lubricant use during specific sexual behaviors, frequency of lubricant use, and reasons for lubricant use. Results. Most men in the United States (70%, N = 1,014) reported having used a commercial lubricant, with men older than 24 and those in a relationship more likely to report lubricant use. About one in four men had used a lubricant in the past 30 days. Intercourse was the most common behavior during which men used lubricant, though solo masturbation and partnered sexual play were also frequently linked to lubricant use. The most common reasons for lubricant use included “to make sex more comfortable,” “for fun,” “curiosity,” and “my partner wanted to.” Conclusions. Most American men have used a lubricant; lubricant use is common across all age groups, and some of the most common reasons why men report using lubricants have to do with sexual enhancement, comfort, and pleasure. Clinicians may find these data helpful to their efforts to educate patients about lubricant use, comfort during sex, and sexual enhancement. Reece M, Herbenick D, Schick V, Sanders SA, and Fortenberry JD. Men’s use and perceptions of commercial lubricants: Prevalence and characteristics in a nationally representative sample of American adults. J Sex Med 2014;11:1125–1135. Key Words. Lubricant; Sexual Pleasure; Men’s Sexual Health
Introduction
M
ost research on men’s use of commercial lubricants during sexual activities is in the context of condom use (i.e., the relation of lubricant use to condom breakage and slippage) and © 2014 International Society for Sexual Medicine
often focuses on lubricant use among men who have sex with men (MSM), with greatest attention to condom use and receptive anal sex [1–5]. This research focus is important—especially as MSM remain disproportionately affected by sexually transmitted infections (including HIV) [6]; J Sex Med 2014;11:1125–1135
1126 however, it often leaves out other aspects of men’s sexual lives [7]. Further, it reinforces gendered stereotypes that men are sexually self-centered (or, at least, not involved in or responsible for the use of lubricant during male–female sexual encounters) and that lubrication and sexual penetration reflect a feminine gender role during partnered sexual experiences. Yet substantial research shows much more nuanced expressions of gender in partnered relationships and suggests a broader incorporation of sexual aids such as lubricants in men’s sexual partnerships [8]. For example, many men in the United States prefer the feel of a “wet” rather than “dry” vagina during penile–vaginal intercourse [9], and many women prefer sex to feel wet as well [10]. Men with female sexual partners may choose lubricants to supplement vaginal wetness as many women experience vaginal dryness in connection with breastfeeding, menopause, some phases of the menstrual cycle, and various health conditions [11–13]. Although sexual health educators and clinicians often recommend lubricant use during anal sex, men’s and women’s preferences for anal sex that is more wet or dry have not been well researched and remain poorly understood. Lubricants may also be chosen for using during sexual activities to decrease pain, increase comfort, as well as to increase a partner’s pleasure and satisfaction with sex [9,12–14]. Also, women commonly indicate that they first began using lubricant during sexual activities because of a partner’s suggestion, highlighting the role of couple interactions in sexual decision making [15]. In recent years, commercial lubricants have become more widely marketed and are commonly available in mainstream retail stores and drug stores in the United States [16,17]. Widespread emphasis on men’s condom use may also have influenced greater acceptability of lubricant use given that most condoms are prelubricated, typically with silicone lubricant. Although there is a small but growing body of literature related to women’s use of lubricant during sexual activities for sexual enhancement as well as for pain reduction [10–15], there is less research about men’s use of lubricants outside the context of sex between men and HIV risk. However, many men may use lubricant for a variety of solo and partnered sexual experiences. Men may use lubricant while they masturbate alone or with a partner, during foreplay or partnered sex play, during vaginal or anal intercourse, and—given the availability of flavored J Sex Med 2014;11:1125–1135
Reece et al. lubricant—perhaps during oral sex as well. It is important to understand more about men’s lubricant use for several reasons: (i) to learn more about men’s sexuality apart from a risk-focused model; (ii) to understand more about how men choose to modulate their sexual experiences to enhance their or their sexual partner’s arousal, comfort, and/or orgasm; and (iii) to assess how men feel about lubricant use. The latter points, in particular, may be important in understanding men’s willingness to use lubricant either to enhance their own sexual experiences or to be responsive to their sexual partner’s needs (related to pain reduction or pleasure) and desires. Aim
The purpose of these analyses, which are based on data from the 2012 National Survey of Sexual Health and Behavior (2012 NSSHB), is to document the prevalence of commercial lubricant use among adult men (age over 18 years) in the United States, to document men’s use of lubricants across solo and partnered sexual behaviors, and to assess men’s perceptions of the contributions lubricants have to the sexual experience. Methods
This article presents data from the 2012 NSSHB, a population-based cross-sectional survey of adults in the United States. Data were collected during October to November 2012 via the KnowledgePanel of GfK Custom Research (GfK) (Menlo Park, California). Research panels accessed through GfK’s KnowledgePanel are based on a national probability sample established using both random digit dialing and an addressbased sampling (ABS) frame. ABS involves the probability sampling of a frame of residential addresses in the United States derived from the U.S. Postal Service’s Delivery Sequence File, a system that contains detailed information on every mail-deliverable address in the United States. Collectively, the sampling frame from which participants are recruited covers approximately 98% of all U.S. households. Randomly selected addresses are recruited to the research panel through a series of mailings and subsequently by telephone followups to nonresponders when possible. To further correct sources of sampling and nonsampling error, study samples are corrected with a poststratification adjustment using demographic distributions from the most recent data available
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Men’s Lubricant Use from the current population survey, the monthly population survey conducted by the U.S. Bureau of the Census considered to be the standard for measuring demographic and other trends in the United States. These adjustments result in a panel base weight that was employed in a probability proportional to size selection method for establishing the samples for this study. Once the sample frame was established, all individuals within that frame received a recruitment message from GfK that provided a brief description of the NSSHB and invited them to participate. A total of 6,175 adults were included in the initial sampling frame, with 61.5% (N = 4,020) viewing the informed consent. Of those viewing the informed consent, 81.7% (N = 3,285) consented to participate, with a total of 3,138 of those individuals (95.5%) completing the survey. Of these participants, 48.1% (N = 1,510) were identified as men and are included in the current analyses. The survey was administered in either English or Spanish. All data were collected by GfK via the Internet; participants in a given GfK KnowledgePanel were provided with access to the Internet and hardware if needed. Multiple researchers have used GfK’s KnowledgePanel for multiple health-related studies, substantiating the validity of such methods for obtaining data from nationally representative samples of the U.S. population [18–24]. Main Outcome Measures
Commercial Lubricant Use Participants were asked to provide details about the extent to which they had used a lubricant. Response options included that participants had used a lubricant within the 30 days prior to participating in the study, 90 days prior to the study, within the past 12 months, more than 1 year ago, or never. Participants were provided with a definition of lubricant that included “any personal lubricant or vaginal moisturizer that you can purchase in a store marketed to enhance the sexual experience and/or increase lubrication.” Commercial Lubricant Use During Specific Sexual Behaviors and Other Product Use Participants were also asked (using the same response categories as above) to describe whether they had used a lubricant during specific sexual behaviors, including while masturbating alone,
during sexual play or foreplay with a partner, and during intercourse. Participants were also asked to respond similarly as to whether they had used a lubricant in conjunction with a condom, a vibrator, or a dildo.
Reasons for Commercial Lubricant Use Men were asked to provide the main reasons for their initial use of a lubricant, with 18 response options including “to make sex feel more wet” to “because my partner wanted to” and “to spice up my/our sex life” among others. Perceptions of Commercial Lubricant Use Participants were asked to respond to the extent to which they agreed or disagreed with items related to their perceptions of the use of lubricant during sexual activities. These items ranged from those such as “lubricant use is embarrassing” to “lubricant makes sex feel better” to “lubricant is only for older people.” Response options included a fourpoint response scale ranging from strongly disagree to strongly agree. Data Analyses During analyses, poststratification data weights were used to minimize bias because of nonsampling error. Distributions for age, race, sex, Hispanic ethnicity, education, and U.S. census region were used in poststratification adjustments. A series of bivariate logistic regressions were used to investigate the relationship between various sociodemographic characteristics (i.e., age, education, race/ethnicity, sexual orientation, relationship status) and lifetime lubricant use. Recency, frequency, perceptions, and reasons for lubricant use were explored using descriptive statistics (e.g., frequencies).
Results
Sociodemographic Characteristics As can be seen in Table 1, participants ranged in age from 18 to 89 (M = 46.13, standard deviation = 16.84). Over half reported some college or completion of college. Most participants were white, non-Hispanic with a sizable minority of participants indicating that they were black, nonHispanic (10.7%, N = 162), or Hispanic (15.2%, N = 229). Most participants were identified as heterosexual (93.6%, N = 1,384), and 53.8% (N = 806) reported living with their spouse. J Sex Med 2014;11:1125–1135
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Table 1 Participant sociodemographic distribution by lifetime lubricant use history using poststratification weights (N = 1,510) Lubricant Use
No Lubricant Use
Lubricant Use vs. No Lubricant Use
Characteristics
% (N)
%
odds ratio (95% CI)
Age 18–24 (ref) 25–29 30–39 40–49 50–59 60–69 70+
10.9 (164) 11.2 (169) 16.6 (251) 18.7 (283) 18.5 (279) 15.1 (228) 9.1 (137)
49.7 77.1 73.2 74.5 71.9 67.0 70.4
50.3 22.9 26.8 25.5 28.1 33.0 29.6
3.39**** (2.09–5.49) 2.73**** (1.78–4.19) 2.94**** (1.94–4.47) 2.56**** (1.69–3.87) 2.04**** (1.33–3.13) 2.40**** (1.48–3.92)
Education Less than high school (ref) High school or GED Some college or associates degree College degree or higher
12.5 (189) 31.4 (474) 27.3 (412) 28.8 (436)
62.5 68.6 70.1 74.6
37.5 31.4 29.9 25.4
1.31 (0.91–1.90) 1.41 (0.97–2.05) 1.76*** (1.21–2.58)
Race/ethnicity White, non-Hispanic (ref) Black, non-Hispanic Other, non-Hispanic Hispanic More than two races, non-Hispanic
67.3 (1016) 10.7 (162) 5.6 (84) 15.2 (229) 1.2 (19)
72.6 64.0 61.3 64.7 78.9
27.4 36.0 38.7 35.3 21.1
0.67* (0.46–0.96) 0.61* (0.37–0.99) 0.69* (0.50–0.94) 1.60 (0.50–5.09)
Sexual orientation Heterosexual (ref) Homosexual/gay Bisexual Asexual Other
93.6 (1384) 4.2 (63) 1.2 (17) 0.6 (9) 0.4 (6)
69.2 98.4 68.8 60.0 50.0
30.8 1.6 31.3 40.0 50.0
20.27**** (3.65–112.65) 0.86 (0.30–2.43) 0.70 (0.10–4.84) 0.57 (0.11–2.80)
Relationship status Single and not dating (ref) Single and dating In a relationship but not living together Living with relationship partner Married and living together Married but not living together
19.5 (293) 6.8 (101) 7.7 (116) 10.5 (158) 53.8 (806) 1.6 (24)
55.5 59.4 69.3 76.2 76.0 56.0
44.5 40.6 30.7 23.8 24.0 44.0
1.18 (0.74–1.87) 1.83** (1.16–2.91) 2.62**** (1.67–4.12) 2.56**** (1.92–3.40) 1.07 (0.46–2.46)
*P ≤ 0.05. **P ≤ 0.01. ***P ≤ 0.005. ****P ≤ 0.001 CI = confidence interval
Lubricant Use History Lubricant use history significantly varied based upon all sociodemographic characteristics assessed (Table 1). Relative to 18- to 24-year-olds, the odds of participants in older age cohorts reporting lifetime lubricant use were two to three times higher (P < 0.001). The odds of lubricant use were higher among college graduates (P < 0.001) and white, non-Hispanic participants (P < 0.05) than other groups. Participants who were identified as gay/ homosexual were more likely to report lubricant use than men who were identified as straight/ heterosexual (P < 0.001). Finally, those in a relationship were more likely to use lubricant than those who were single and not dating (P < 0.01). Overall, 70% (N = 1,014) of men indicated that they had used a lubricant at least once within their lifetime (Table 2). A total of 25.4% (N = 368) reported that they had used a lubricant within the past 30 days. Rates of lubricant use were the lowest J Sex Med 2014;11:1125–1135
amongst 18- to 24-year-olds, with 25% more having done so in some older age cohorts. After age 25, lubricant use rates are similar across age groups. That so many more men have used lubricant after age 25 may reflect the greater proportions of men who begin having vaginal intercourse, or more frequent vaginal intercourse, in their 20s [9]. Regarding men’s context of use, approximately half of the participants indicated that they had used lubricant during solo masturbation (49.9%, N = 717) or during partnered sexual play (54.3%, N = 782) with the highest percentage of participants indicating that they had used a lubricant during partnered intercourse (62.3%, N = 892).
Lubricant Use with Condoms,Vibrators, and Dildos Participants were also asked about their use of lubricants with condoms, vibrators, and dildos. About 41% (N = 586) of men reported using a
54.3 (782) 14.0 (201) 8.6 (124) 9.1 (131) 22.7 (326)
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Used a lubricant during partnered sexual play
Used a lubricant during partnered intercourse
Used a lubricant with a condom
Used a lubricant with a vibrator
Used a lubricant with a dildo
The bold text is to highlight the “Ever used” data.
49.9 (717) 17.3 (249) 7.2 (104) 7.7 (110) 17.7 (254)
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Used a lubricant during solo masturbation
21.2 (306) 3.1 (45) 3.0 (44) 3.1 (45) 12.0 (173)
28.5 (406) 4.5 (64) 3.7 (52) 4.9 (69) 15.5 (220)
40.8 (586) 5.8 (84) 3.0 (44) 5.9 (84) 26.0 (375)
62.3 (892) 19.5 (280) 8.7 (124) 10.2 (146) 23.9 (342)
% (N) 70.0 (1014) 25.4 (368) 10.1 (147) 12.2 (176) 22.3 (323)
Ever used Past 30 days Past 90 days Past 12 months (Year) More than a year ago
Used a lubricant
Total sample
7.1 (11) 1.1 (2) 0.8 (1) 3.4 (5) 1.8 (3)
12.1 (18) 0.9 (1) 3.8 (6) 4.2 (6) 3.2 (5)
24.6 (37) 8.3 (13) 3.7 (6) 8.4 (13) 4.2 (6)
34.2 (52) 10.7 (16) 6.8 (10) 10.8 (16) 5.8 (9)
24.0 (36) 3.4 (5) 4.0 (6) 9.0 (14) 7.6 (11)
34.0 (51) 12.3 (19) 10.1 (15) 5.8 (9) 5.8 (9)
49.9 (76) 18.1 (28) 7.3 (11) 15.5 (24) 9.0 (14)
% (N)
18–24
24.0 (40) 1.5 (3) 9.0 (15) 2.2 (4) 11.3 (19)
39.2 (64) 4.0 (7) 7.4 (12) 8.7 (14) 19.1 (31)
51.2 (85) 12.0 (20) 5.7 (9) 7.7 (13) 25.9 (43)
62.6 (102) 19.4 (32) 13.2 (21) 11.7 (19) 18.3 (30)
56.0 (92) 14.7 (24) 12.4 (21) 10.4 (17) 18.4 (30)
54.7 (88) 19.4 (31) 10.2 (17) 9.1 (15) 15.9 (26)
77.2 (128) 27.7 (46) 18.0 (30) 13.2 (22) 18.3 (30)
25–29
Weighted lifetime and recency of lubricant use during various sexual contexts
Recency of lubricant use
Table 2
23.7 (57) 4.3 (10) 3.1 (7) 5.0 (12) 11.4 (27)
32.0 (74) 6.4 (15) 4.0 (9) 5.2 (12) 16.4 (38)
52.4 (125) 6.1 (14) 3.7 (9) 8.5 (20) 34.1 (82)
67.9 (160) 19.8 (47) 10.7 (25) 13.0 (31) 24.4 (58)
61.6 (148) 14.0 (34) 10.1 (24) 11.3 (27) 26.2 (63)
63.4 (152) 22.5 (54) 9.8 (24) 8.9 (21) 22.2 (53)
73.2 (175) 23.8 (57) 10.8 (26) 14.8 (35) 23.8 (57)
30–39
28.4 (77) 5.8 (16) 2.8 (8) 4.5 (12) 15.3 (41)
36.0 (98) 6.6 (18) 3.3 (9) 5.4 (15) 20.6 (56)
50.6 (137) 5.6 (15) 2.0 (5) 7.7 (21) 35.3 (96)
67.6 (183) 25.1 (68) 7.6 (20) 11.3 (30) 23.8 (64)
63.6 (173) 18.4 (50) 10.6 (29) 12.6 (34) 22.2 (60)
59.5 (162) 21.0 (57) 10.7 (29) 8.8 (24) 18.9 (51)
74.6 (204) 30.2 (83) 10.8 (30) 11.3 (31) 22.2 (61)
40–49
27.5 (73) 2.9 (8) 4.1 (11) 2.4 (6) 18.1 (48)
31.7 (83) 5.6 (15) 3.3 (9) 4.6 (12) 18.1 (48)
37.3 (99) 5.6 (15) 4.0 (11) 4.4 (12) 23.2 (62)
65.7 (175) 23.3 (62) 10.3 (27) 8.6 (23) 23.6 (63)
60.8 (161) 15.0 (40) 12.1 (32) 8.2 (22) 25.4 (67)
48.1 (128) 18.0 (48) 4.5 (12) 6.4 (17) 19.3 (51)
71.8 (192) 30.5 (81) 12.1 (32) 8.1 (22) 21.1 (56)
50–59
16.8 (37) 1.4 (3) 0.2 (1) 2.7 (6) 12.6 (27)
24.7 (52) 3.9 (8) 2.3 (5) 3.2 (7) 15.3 (32)
30.1 (64) 1.9 (4) 1.6 (3) 2.6 (6) 24.0 (51)
64.1 (138) 18.7 (40) 6.5 (14) 8.5 (18) 30.4 (65)
50.1 (106) 15.5 (33) 4.0 (9) 7.5 (16) 23.0 (49)
45.2 (96) 14.6 (31) 1.9 (4) 9.3 (20) 19.4 (41)
67.1 (144) 24.6 (53) 5.6 (12) 13.8 (30) 23.0 (49)
60–69
5.9 (8)
5.9 (8) 2.6 (3) 0.9 (1)
12.2 (16) 0.4 (1) 1.9 (3) 2.1 (3) 7.8 (10)
29.1 (38) 1.9 (3) 0.4 (1) 0.2 (0) 26.5 (35)
63.1 (83) 11.5 (15) 4.2 (5) 6.6 (9) 40.8 (54)
48.7 (66) 11.4 (15) 2.6 (3) 1.2 (2) 33.5 (45)
29.8 (40) 6.9 (9) 2.3 (3) 3.5 (5) 17.1 (23)
70.6 (95) 15.3 (21) 4.4 (6) 9.4 (13) 41.5 (56)
70+
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lubricant with a condom with the greatest proportion reporting that their most recent use was over a year ago. Of those who used lubricant with a condom, most indicated that they applied the lubricant to the outside of the condom (81.6%, N = 172) or on the inside and outside of the condom (11.6%, N = 24). A sizable minority of participants reported using a lubricant with a vibrator (28.5%, N = 406) or dildo (21.2%, N = 306).
cant during sexual activities “makes sex more comfortable” (85.2%, N = 828). More than two-thirds also agreed with the statements that lubricant “makes it easier to feel aroused” (69.4%, N = 686) and “makes sex feel better” (77.1%, N = 757), and more than half agreed that it “makes it easier to have an orgasm” (56.1%, N = 551). In contrast, only 10% (N = 96) of men agreed that lubricant “is only for older people.”
Lubricant Use Frequency As described in Table 3, participants who reported using a lubricant within the past 90 days were asked about their frequency of lubricant use within that time period. Generally, participants were most likely to report that they used a lubricant in these specific situations “once or twice” or “more than 10 times.” These were also the most frequently endorsed response categories for participants reporting lubricant use for each of the three sexual behaviors (e.g., during solo masturbation) and lubricant use with a condom. However, when asked about lubricant use with a vibrator or dildo, the most commonly endorsed category included “once or twice” followed by “three to five times.” These trends remained fairly consistent across age groups.
Discussion
Reasons for Lubricant Use When participants with a lubricant use history were asked to indicate their reasons for first starting to use a lubricant, the most frequently endorsed item was “to make sex more comfortable” (39.2%, N = 398), followed by “for fun” (36.1%,N = 366), “curiosity” (33.5%, N = 340), and “my partner wanted to” (26.4%, N = 268) (Table 4). For men between the ages of 18 and 49, the most common reasons were “for fun” and “curiosity.” When asked about their reasons for first starting to use lubricants during sexual activities, the most common reasons included “my partner suggested we use a lubricant,” “I wanted to make sex more pleasurable,” and “I wanted to reduce discomfort or pain during sex.” These responses were consistently the most frequently endorsed across age groups. Perceptions of Lubricant Use Participants were asked to indicate agreement with several items regarding their experiences with lubricants (see Table 5). Most men who had used a lubricant agreed with this statement: using lubriJ Sex Med 2014;11:1125–1135
In a nationally representative probability sample of men ages 18 years and older in the United States— the 2012 NSSHB—it was found that most men have used lubricant, lubricant use is prevalent across age cohorts, and men largely use lubricant during sexual activities for reasons related to sexual enhancement, comfort, and pleasure. These data underscore the widespread use of lubricants as sexual enhancement products among men and their sexual partners. Critically, these data also point to the need for scientific knowledge about pleasure and enjoyment aspects of sexuality as an aspect of sexual health not to be lost—or omitted—under the umbrella of public health research. A reading of past research related to lubricant use might lead one to believe that the role of lubricant in men’s sexual lives was predominantly related to risk reduction (e.g., to reduce friction and tearing during anal sex and/or to reduce the risk of condom breakage when two men have anal intercourse). Although the role of lubricant in HIV risk reduction is important to understand from a public health perspective, it does not do justice to the broad range of men’s sexualities and sexual experiences to view their sexual behaviors and perspectives exclusively through a risk-focused lens. Findings from this study paint a more nuanced, and a more interesting, picture of men’s sexual experiences. Men most commonly report using lubricant to make sex more comfortable and often at the suggestion of a partner. This attentiveness that men report to sexual comfort and pleasure is worth noting as it suggests a sense of proactive caring and/or responsiveness to their partners’ suggestions or needs that often go unacknowledged. Indeed, men commonly indicated that they used lubricant to enhance foreplay, to spice up their sex life, and/or to manage vaginal pain or reduce the risk of (vaginal or anal) tearing—all of which suggest an attentiveness to the realities of pleasurable and difficult aspects of sexual
11.0 (56) 26.9 (137) 21.2 (108) 13.2 (67) 27.7 (141)
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Used a lubricant
Used a lubricant during solo masturbation
Used a lubricant during partnered sexual play
Used a lubricant during partnered intercourse
Used a lubricant with a condom
Used a lubricant with a vibrator
Used a lubricant with a dildo
12.9 (11) 43.6 (38) 20.3 (18) 10.3 (9) 12.9 (11)
5.8 (7) 38.7 (45) 25.2 (29) 12.5 (14) 17.9 (21)
10.4 (13) 32.7 (41) 18.6 (23) 15.0 (19) 23.3 (29)
1.9 (8) 29.5 (119) 21.5 (87) 16.3 (66) 30.8 (124)
6.7 (22) 33.0 (107) 21.3 (69) 14.2 (46) 24.9 (81)
4.8 (17) 35.8 (125) 19.8 (69) 14.7 (51) 24.8 (86)
% (N)
Total sample
56.6 (2)
43.4 (1)
6.4 (1) 63.0 (4) 30.6 (2)
12.4 (2) 41.8 (8) 5.5 (1) 23.0 (4) 17.4 (3)
53.7 (14) 13.5 (4) 13.8 (4) 19.0 (5)
44.8 (5) 15.1 (2) 12.4 (1) 10.1 (1) 17.6 (2)
9.3 (3) 27.8 (9) 27.9 (9) 26.5 (9) 8.4 (3)
7.5 (3) 31.9 (12) 33.1 (13) 10.8 (4) 16.8 (7)
% (N)
18–24
57.6 (10) 20.6 (4) 13.0 (2) 8.9 (2)
20.4 (4) 27.6 (5) 16.5 (3) 26.6 (5) 8.8 (2)
14.4 (4) 35.3 (10) 22.6 (7) 16.3 (5) 11.4 (3)
19.8 (11) 27.3 (14) 25.0 (13) 27.8 (15)
2.1 (1) 29.8 (13) 16.8 (8) 22.6 (10) 28.8 (13)
6.8 (3) 35.8 (17) 30.9 (15) 2.2 (1) 24.3 (12)
11.2 (8) 23.8 (17) 22.4 (16) 11.6 (8) 30.9 (22)
25–29
11.0 (2) 51.7 (9) 24.2 (4) 2.3 (1) 10.8 (2)
6.9 (2) 32.0 (8) 38.8 (9) 1.7 () 20.6 (5)
14.1 (3) 16.4 (4) 22.9 (5) 15.2 (3) 31.5 (7)
0.2 (1) 41.3 (30) 17.2 (12) 14.6 (11) 26.7 (19)
5.0 (3) 44.0 (25) 17.0 (10) 12.5 (7) 21.5 (12)
5.2 (4) 39.6 (30) 9.2 (7) 20.9 (16) 25.1 (19)
9.4 (8) 30.1 (25) 20.1 (17) 11.1 (9) 29.3 (24)
30–39
19.9 (4) 33.9 (7) 18.1 (4) 8.5 (2) 19.6 (4)
2.1 (1) 25.3 (7) 35.0 (9) 9.0 (2) 28.6 (8)
3.7 (1) 33.9 (7) 20.9 (4) 3.8 (1) 37.8 (7)
2.5 (2) 27.4 (24) 19.5 (17) 12.2 (11) 38.5 (34)
6.1 (5) 26.5 (21) 21.6 (17) 15.5 (12) 30.4 (24)
5.5 (5) 29.9 (25) 22.2 (19) 17.0 (14) 25.5 (22)
8.9 (10) 26.4 (29) 20.6 (23) 13.4 (15) 30.8 (34)
40–49
12.7 (2) 52.5 (10) 14.7 (3) 6.3 (1) 13.7 (3)
59.4 (14) 21.2 (5) 5.5 (1) 14.0 (3)
1.9 (1) 45.1 (12) 12.9 (3) 17.7 (5) 22.4 (6)
2.5 (2) 27.8 (25) 22.7 (20) 13.1 (12) 33.9 (30)
7.0 (5) 49.4 (36) 19.2 (14) 4.3 (3) 20.1 (14)
1.4 (1) 42.0 (25) 13.1 (8) 10.3 (6) 33.3 (20)
11.9 (14) 31.9 (36) 19.5 (22) 11.1 (13) 25.6 (29)
50–59
Weighted frequency of lubricant used for participants who reported lubricant use in the following contexts within the past 90 days
Recency of lubricant use
Table 3
9.2 (1) 18.1 (1) 48.1 (2) 24.6 (1)
1.5 (1) 43.2 (6) 2.4 (1) 31.8 (4) 21.1 (3)
22.9 (2) 15.5 (1) 22.5 (2) 3.8 (1) 35.5 (3)
4.4 (2) 25.4 (14) 16.9 (9) 21.4 (12) 31.9 (17)
3.9 (2) 24.4 (10) 23.2 (10) 20.9 (9) 27.7 (11)
1.5 (1) 37.3 (13) 19.6 (7) 11.1 (4) 30.6 (11)
18.2 (11) 21.9 (14) 12.4 (8) 20.8 (13) 26.8 (17)
60–69
26.7 (1) 22.0 (1) 18.0 (1) 33.3 (2)
41.0 (1) 18.1 (1)
40.9 (1)
50.4 (2) 30.8 (1)
18.8 (1)
3.7 (1) 9.0 (2) 47.2 (10) 20.5 (4) 19.6 (4)
7.2 (1) 1.6 (1) 52.7 (10) 18.9 (4) 19.6 (4)
3.9 (1) 41.5 (5) 37.8 (5) 10.5 (1) 6.4 (1)
8.7 (2) 10.4 (3) 34.9 (9) 17.2 (5) 28.9 (8)
70+
Men’s Lubricant Use 1131
J Sex Med 2014;11:1125–1135
J Sex Med 2014;11:1125–1135 40.9 (31) 4.8 (4) 6.4 (5) 1.5 (1) 8.8 (7) 8.2 (6) 1.9 (1) 31.5 (24) 8.9 (7) 2.8 (2)
3.7 (37) 0.9 (9) 32.8 (332) 24.9 (252) 5.2 (53)
36.5 (28) 14.4 (11) 34.1 (26) 31.3 (24) 9.3 (7) 4.3 (3) 3.5 (3) 0.0 (0) 0.0 (0) 0.0 (0) 22.4 (17) 0.6 (0) 8.2 (6) 11.4 (9) 6.6 (5) 11.5 (9) 19.7 (15) 6.2 (5)
% (N)
18–24
48.1 (488) 8.9 (91) 10.6 (108) 2.1 (22) 1.4 (15)
36.1 (366) 22.6 (229) 33.5 (340) 26.4 (268) 13.6 (138) 3.3 (33) 2.7 (28) 0.9 (9) 0.7 (7) 4.9 (50) 39.2 (398) 8.1 (82) 11.9 (121) 15.2 (154) 3.9 (40) 22.6 (229) 21.2 (215) 3.7 (37)
Reason for first starting use For fun To enhance foreplay Curiosity My partner wanted us to To spice up my/our sex life A friend said it was fun to use My (or my partner’s) body changed during pregnancy While postpartum/nursing Because of medication use/surgery Approaching menopause To make sex more comfortable To reduce the risk of tearing To manage vaginal pain To comfortably have anal sex To reduce the risk of condom breakage To add pleasurable sensations to sex To make sex feel more wet Other
Reason for first starting use during sexual activities My partner suggested we use a lubricant I saw an advertisement for a lubricant I noticed that lubricated condoms felt more comfortable A doctor or nurse recommended a lubricant A health educator or sex educator recommended a lubricant A friend recommended a lubricant A family member recommended a lubricant I wanted to make sex more pleasurable I wanted to reduce discomfort or pain during sex Other
% (N)
Total sample
Reasons for lubricant use by age using poststratification weights
Reason for use
Table 4
5.9 (8) 1.0 (1) 21.9 (28) 21.2 (27) 4.8 (6)
50.8 (65) 8.9 (11) 14.2 (18) 0.7 (1) 0.0 (0)
39.6 (51) 23.8 (30) 43.2 (55) 25.3 (32) 16.5 (21) 2.1 (3) 0.2 (1) 0.0 (0) 0.0 (0) 0.8 (1) 31.5 (40) 13.1 (17) 10.2 (13) 10.9 (14) 3.0 (4) 18.9 (24) 26.2 (33) 1.8 (2)
25–29
3.1 (5) 1.9 (3) 32.4 (57) 20.7 (36) 4.6 (8)
45.1 (79) 7.0 (12) 14.3 (25) 2.0 (4) 0.2 (1)
48.6 (85) 20.3 (36) 38.5 (68) 23.6 (41) 10.7 (19) 3.6 (6) 2.9 (5) 1.9 (3) 0.6 (1) 0.0 (0) 28.0 (49) 8.7 (15) 8.8 (15) 14.1 (25) 4.8 (8) 20.6 (36) 21.7 (38) 3.8 (7)
30–39
5.5 (11) 0.2 (1) 33.4 (68) 23.5 (48) 3.9 (8)
56.8 (116) 11.1 (23) 11.8 (24) 0.6 (1) 2.9 (6)
40.3 (82) 28.9 (59) 40.4 (83) 29.3 (60) 16.0 (33) 6.8 (14) 3.1 (6) 1.2 (2) 0.1 (1) 2.3 (5) 36.5 (75) 10.1 (21) 11.4 (23) 18.6 (38) 4.0 (8) 26.5 (54) 21.8 (45) 3.4 (7)
40–49
2.3 (4) 0.5 (1) 36.8 (71) 34.2 (66) 6.5 (13)
44.7 (86) 9.3 (18) 9.5 (18) 1.1 (2) 0.1 (1)
29.5 (57) 23.3 (45) 22.9 (44) 26.3 (51) 12.3 (24) 2.5 (5) 1.8 (3) 1.2 (2) 0.1 (1) 7.5 (14) 49.8 (95) 6.8 (13) 9.5 (18) 21.7 (42) 3.4 (7) 22.3 (43) 18.8 (36) 4.9 (9)
50–59
1.3 (2) 1.0 (1) 37.0 (53) 28.7 (41) 9.7 (14)
43.7 (63) 10.7 (15) 9.4 (14) 4.0 (6) 0.2 (1)
31.0 (45) 23.0 (33) 29.1 (42) 22.3 (32) 18.0 (26) 1.4 (2) 2.1 (3) 0.6 (1) 0.0 () 15.2 (22) 49.2 (71) 6.3 (9) 17.0 (25) 14.5 (21) 3.5 (5) 26.6 (38) 21.9 (31) 4.3 (6)
60–69
0.8 (1) 0.6 (1) 33.1 (31) 28.7 (27) 1.9 (2)
50.8 (48) 7.6 (7) 3.9 (4) 7.2 (7) 1.2 (1)
20.2 (19) 16.3 (15) 23.8 (23) 29.1 (28) 9.7 (9) 0.0 (0) 7.5 (7) 0.0 (0) 5.9 (6) 8.0 (8) 53.5 (51) 6.9 (7) 21.6 (20) 6.2 (6) 2.6 (2) 26.3 (25) 17.6 (17) 1.2 (1)
70+
1132 Reece et al.
1133
54.8 70 50.2 64 54.3 69 17.8 22 69.4 83 45.2 58 49.8 63 45.7 58 82.2 103 30.6 37 62.3 127 50.2 101 70.3 142 16.1 32 78.5 154 37.7 77 49.8 100 29.7 60 83.9 168 21.5 42 56.3 143 47.9 120 64.2 162 10.2 25 73.6 184 43.7 111 52.1 131 35.8 90 89.8 220 26.4 66 67.1 180 54.8 147 68.8 184 11.9 32 76.3 203 32.9 88 45.2 121 31.2 84 88.1 234 23.7 63 58.8 133 51.4 116 67.3 152 14.4 31 73.1 164 41.2 93 48.6 110 32.7 74 85.6 187 26.9 61 57.8 95 40.7 66 66.3 106 13.8 22 66.6 109 42.2 69 59.3 96 33.7 54 86.2 137 33.4 55 73.3 102 58.1 81 66.8 92 28.1 37 70.3 98 26.7 37 41.9 58 33.2 46 71.9 96 29.7 41 61.5 850 50.5 695 66.1 908 15.0 202 73.2 995 Makes
Is only
Makes
Makes
% 38.5 N 533 it easier to have an orgasm % 49.5 N 680 sex feel better % 33.9 N 465 for older people % 85.0 N 1,146 sex more comfortable % 26.8 N 364 Makes it easier to feel aroused
Disagree Agree Disagree Agree Disagree Agree Disagree Agree Disagree Agree Disagree Agree Disagree Agree Disagree Agree
25–29 18–24 Total
Using lubricant during sexual activities
Table 5
Perceptions of lubricant use by age using poststratification weights
30–39
40–49
50–59
60–69
70+
Men’s Lubricant Use
experience, and a desire to create sexual experiences with a partner who feels mutually pleasurable and satisfying. Although women’s roles in sexual enhancement have often been noted, men’s involvement in sexual pleasure enhancement has perhaps less often been highlighted. These data suggest that men, like women, take active roles in creating pleasurable sexual lives. Men also reported using a lubricant in a variety of contexts including solo masturbation, partnered sex play, intercourse, and in association with the use of condoms, vibrators, and dildos. Although much of the paired product use (i.e., lubricant with condom, lubricant with vibrator or dildo) occurred more than a year ago—perhaps suggesting that condoms, vibrators, or dildos themselves have not been used as recently—nearly one in five men reported using a lubricant during solo masturbation in the past 30 days. Similarly, one in five men reported using a lubricant during intercourse in the past 30 days. This study had several strengths and limitations. A significant strength is that sexual behavior and lubricant use were assessed in a nationally representative probability sample of American men ages 18 and older. Participants were able to complete the survey via the Internet, thus facilitating privacy and ease of access. Men were eligible to be part of the GfK’s KnowledgePanel—and thus part of the study—regardless of their personal financial or technological resources. That is, if they lacked Internet access or the hardware or software necessary to complete Internet-based surveys for the panel, they were provided with the needed resources as part of GfK membership. Participants were also already familiar with completing GfK surveys and thus did not require additional training regarding survey completion. A limitation is that the sample was restricted to individuals who had a home address and who were community dwelling (e.g., not institutionalized or homeless). This may have limited the sample, particularly for much older individuals and/or those experiencing health conditions that warrant inpatient care. Some men may not have felt comfortable answering questions about their sexual or lubricant use behaviors or may not have understood the questions (and because the survey was administered online, they would not have been able to ask for clarification). Also, it may be that participants who agreed to participate in a survey about sexual behavior or lubricant use have different experiences or attitudes about sexuality or lubricants compared with individuals who chose J Sex Med 2014;11:1125–1135
1134 not to participate in the research. Additionally, this study included only individuals—not couples— and subsequent research may benefit from including partners’ perspectives. Subsequent research might also be attentive to recent and event-level lubricant use, providing insights into how lubricants are used for specific sexual activities within context. Finally, although we defined what we meant by a “lubricant” at various points throughout the survey, it is possible that some participants had different definitions in mind. However, we expect that this number would be small enough so as not to have a significant influence on our findings. As sexual enhancement products become more widely available and marketed, research needs to be attentive to potential changes in men’s and women’s sexual lives with increasing integration of such products into sexual activities. The diverse ways in which lubricants are used by men indicate that lubricants are likely to be applied to a variety of body sites and may enter various orifices including the mouth, anus/rectum, urethra, and vagina. Clinicians practicing in a variety of specialties (e.g., dermatology, urology, sexual medicine, internal medicine, gynecology) need to know how and where men and their sexual partners apply lubricants or how they otherwise use sexual enhancement products (including condoms, vibrators, and dildos) as part of their solo and partnered sexual experiences. A greater knowledge base of human sexual behavior and consumer product use may provide insights into patients’ sexual health—for example, the extent to which patients are using lubricants to address a problem (such as their own or a partner’s genital pain or discomfort during sex) or to enhance an already pleasurable sex life. Clinicians might consider, too, the extent to which they might suggest lubricant use as a means of sexual enhancement for patients who inquire about ways to enhance their own arousal, ease of orgasm, comfort, or pleasure during sex. Finally, these data provide additional insights into the broader experience of male sexuality. Too often, men’s sexual experiences are couched in risk (e.g., HIV/AIDS risk and associated risk reduction strategies), danger (e.g., sexual assault and rape), or dysfunction (e.g., erectile dysfunction), with little attention given to collecting data and creating evidence-based communications about the diverse ways men experience their sexual lives. These data complement findings from a parallel study of women’s use of lubricant [24], which demonstrate that pleasure, enhancement, and sexual comfort/ J Sex Med 2014;11:1125–1135
Reece et al. pain reduction are important reasons that both sexes first use lubricants. Such characteristics appear to be of value to many men as well as to many women, highlighting the efforts that both sexes make to please each other while at the same time pleasing oneself through sexual expression. Conclusions
Findings from the 2012 NSSHB demonstrate that most American men have used a lubricant, that lubricant use is common across all age groups, and that some of the most common reasons why men report using lubricant have to do with sexual enhancement, comfort, and pleasure. Clinicians may find these data helpful to their efforts to educate patients about lubricant use, comfort during sex, and sexual enhancement. Acknowledgments
This study was partially funded by Church & Dwight, Co., Inc. Corresponding Author: Debby Herbenick, PhD, MPH, Center for Sexual Health Promotion, Indiana University, Bloomington, IN 47405, USA. Tel: 812855-0364; Fax: 812-855-3936; E-mail: debby@ indiana.edu Conflict of Interest: Michael Reece is a member of the sexual health advisory council of Church & Dwight Co., Inc. Statement of Authorship
Category 1 (a) Conception and Design Michael Reece; Debby Herbenick; Vanessa Schick; Stephanie A. Sanders; J. Dennis Fortenberry (b) Acquisition of Data Michael Reece; Debby Herbenick; Vanessa Schick; Stephanie A. Sanders; J. Dennis Fortenberry (c) Analysis and Interpretation of Data Vanessa Schick; Debby Herbenick
Category 2 (a) Drafting the Article Debby Herbenick; Michael Reece; Vanessa Schick (b) Revising It for Intellectual Content Michael Reece; Debby Herbenick; Vanessa Schick; Stephanie A. Sanders; J. Dennis Fortenberry
Category 3 (a) Final Approval of the Completed Article Michael Reece; Debby Herbenick; Vanessa Schick; Stephanie A. Sanders; J. Dennis Fortenberry
Men’s Lubricant Use References 1 Carballo-Dieguez A, Stein Z, Saez H, Dolezal C, Nieves-Rosa L, Diaz F. Frequent use of lubricants for anal sex among men who have sex with men: The HIV prevention potential of a microbicidal gel. Am J Public Health 2000;90:1117–21. 2 Phillips DM, Sudol KM, Taylor CL, Guichard L, Elsen R, Maguire R. Lubricants containing N-9 may enhance rectal transmission of HIV and other STIs. Contraception 2004;70:107–10. 3 Richters J, Gerofi J, Donovan B. Why do condoms break or slip off in use? An exploratory study. Int J STD AIDS 1995;6:11–8. 4 Trussell J, Warner DL, Hatcher RA. Condom slippage and breakage rates. Fam Plann Perspect 1992;24:20–3. 5 Voeller B, Coulson A, Bernstein G, Nakamura R. Mineral oil lubricants cause rapid deterioriation of latex condoms. Contraception 1989;39:95–102. 6 Centers for Disease Control and Prevention. HIV/AIDS surveillance report, 2006. Vol. 18. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.; 2006. Available at: http://www.cdc.gov/hiv/ topics/surveillance/resources/reports/ (accessed July 16, 2013). 7 Reece M, Dodge B. A study in sexual health applying the principles of community-based participatory research. Arch Sex Behav 2004;33:235–47. 8 Reece M, Mark K, Herbenick D, Hensel DJ, Jawed-Wessel S, Dodge B. An event-level analysis of adding exogenous lubricant in a sample of men who have vaginal sex with women. J Sex Med 2012;9:672–8. 9 Foxman B, Aral SO, Holmes KK. Interrelationships among douching practices, risky sexual practices, and history of selfreported sexually transmitted diseases in an urban population. Sex Transm Dis 1998;25:90–9. 10 Jozkowski KN, Herbenick D, Schick V, Reece M, Sanders SA, Fortenberry JD. Women’s perceptions about lubricant use and vaginal wetness during sexual activities. J Sex Med 2013;10:484–92. 11 Sutton KS, Boyer SC, Goldfinger C, Ezer P, Pukall CF. To lube or not to lube: Experiences with perceptions of lubricant use in women with and without dyspareunia. J Sex Med 2012;9:240–50. 12 Emilee G, Ussher JM, Perz J. Sexuality after breast cancer: A review. Maturitas 2010;66:397–407.
1135 13 Tan O, Bradshaw K, Carr B. Management of vulvovaginal atrophy-related sexual dysfunction in postmenopausal women: An up-to-date review. Menopause 2012;19:109–17. 14 Herbenick D, Reece M, Hensel D, Sanders SA, Jozkowski K, Fortenberry JD. Association of lubricant use with women’s sexual pleasure, sexual satisfaction, and genital symptoms: A prospective daily diary study. J Sex Med 2011;8:202–12. 15 Herbenick D, Reece M, Schick V, Sanders SA, Fortenberry JD. Women’s use and perceptions of commercial lubricants: Prevalence and characteristics in a nationally representative sample of American adults. J Sex Med 2014. doi:10.1111/ jsm.12427. [Epub ahead of print]. 16 Schrobsdorff S. Red-light specials. Newsweek 2008. Available at: http://www.newsweek.com/id/110965 (accessed July 16, 2013). 17 Butler E. Steaming up the aisles. 2006. Available at: http:// www.crainsnewyork.com/article/20061029/FREE/61028016 (accessed July 16, 2013). 18 Baker L, Wagner TH, Singer S, Bundorf MK. Use of the internet and e-mail for health care information: Results from a national survey. JAMA 2003;289:2400–6. 19 Heiss F, McFadden D, Winter J. Who failed to enroll in Medicare Part D, and why? Early results. Health Aff 2006;25:344–54. 20 Silver RC, Holman EA, McIntosh DN, Poulin M, Gil-Rivas V. Nationwide longitudinal study of psychological responses to September 11. JAMA 2002;288:1235. 21 Sanders SA, Reece M, Herbenick D, Schick V, Dodge B, Fortenberry JD. Condom use during most recent vaginal intercourse event among a probability sample of adults in the United States. J Sex Med 2010;7(suppl 5):362–73. 22 Reece M, Herbenick D, Schick V, Sanders SA, Dodge B, Fortenberry JD. Sexual behaviors, relationships, and perceived health among adult men in the United States: Results from a national probability sample. J Sex Med 2010;7(suppl 5):291– 304. 23 Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, Fortenberry JD. Sexual behaviors, relationships, and perceived health among adult women in the United States: Results from a national probability sample. J Sex Med 2010;7(suppl 5):277– 90. 24 Herbenick D, Reece M, Sanders SA, Dodge B, Ghassemi A, Fortenberry JD. Prevalence and characteristics of vibrator use by women in the United States: Results from a nationality representative study. J Sex Med 2009;6:1857–66.
J Sex Med 2014;11:1125–1135
Men’s Use and Perceptions of Commercial Lubricants: Prevalence and Characteristics in a Nationally Representative Sample of American Adults Michael Reece, PhD, MPH,* Debby Herbenick, PhD, MPH,* Vanessa Schick, PhD,† Stephanie A. Sanders, PhD,‡§ and J. Dennis Fortenberry, MD, MS¶ *Center for Sexual Health Promotion, Indiana University, Bloomington, IN, USA; †University of Texas, Houston, TX, USA; ‡ The Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA; § Department of Gender Studies, Indiana University, Bloomington, IN, USA; ¶Division of Adolescent Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA DOI: 10.1111/jsm.12480
ABSTRACT
Introduction. Most research on men’s use of commercial lubricants during sexual activities is in the context of condom use and often specifically among men who have sex with men. Less is known about men’s use of lubricants associated with a broader range of sexual experiences. Aims. The aims of this study are to document the prevalence of commercial lubricant use among adult U.S. men (age 18+), to document men’s use of lubricants across solo and partnered sexual behaviors, and to assess men’s perceptions of the contributions lubricants have to the sexual experience. Methods. Data are from the 2012 National Survey of Sexual Health and Behavior, which involved the administration of an online questionnaire to a nationally representative probability sample of U.S. adults ages 18 and older. Main Outcome Measures. Sociodemographic characteristics, recent and lifetime commercial lubricant use, lubricant use during specific sexual behaviors, frequency of lubricant use, and reasons for lubricant use. Results. Most men in the United States (70%, N = 1,014) reported having used a commercial lubricant, with men older than 24 and those in a relationship more likely to report lubricant use. About one in four men had used a lubricant in the past 30 days. Intercourse was the most common behavior during which men used lubricant, though solo masturbation and partnered sexual play were also frequently linked to lubricant use. The most common reasons for lubricant use included “to make sex more comfortable,” “for fun,” “curiosity,” and “my partner wanted to.” Conclusions. Most American men have used a lubricant; lubricant use is common across all age groups, and some of the most common reasons why men report using lubricants have to do with sexual enhancement, comfort, and pleasure. Clinicians may find these data helpful to their efforts to educate patients about lubricant use, comfort during sex, and sexual enhancement. Reece M, Herbenick D, Schick V, Sanders SA, and Fortenberry JD. Men’s use and perceptions of commercial lubricants: Prevalence and characteristics in a nationally representative sample of American adults. J Sex Med 2014;11:1125–1135. Key Words. Lubricant; Sexual Pleasure; Men’s Sexual Health
Introduction
M
ost research on men’s use of commercial lubricants during sexual activities is in the context of condom use (i.e., the relation of lubricant use to condom breakage and slippage) and © 2014 International Society for Sexual Medicine
often focuses on lubricant use among men who have sex with men (MSM), with greatest attention to condom use and receptive anal sex [1–5]. This research focus is important—especially as MSM remain disproportionately affected by sexually transmitted infections (including HIV) [6]; J Sex Med 2014;11:1125–1135
1126 however, it often leaves out other aspects of men’s sexual lives [7]. Further, it reinforces gendered stereotypes that men are sexually self-centered (or, at least, not involved in or responsible for the use of lubricant during male–female sexual encounters) and that lubrication and sexual penetration reflect a feminine gender role during partnered sexual experiences. Yet substantial research shows much more nuanced expressions of gender in partnered relationships and suggests a broader incorporation of sexual aids such as lubricants in men’s sexual partnerships [8]. For example, many men in the United States prefer the feel of a “wet” rather than “dry” vagina during penile–vaginal intercourse [9], and many women prefer sex to feel wet as well [10]. Men with female sexual partners may choose lubricants to supplement vaginal wetness as many women experience vaginal dryness in connection with breastfeeding, menopause, some phases of the menstrual cycle, and various health conditions [11–13]. Although sexual health educators and clinicians often recommend lubricant use during anal sex, men’s and women’s preferences for anal sex that is more wet or dry have not been well researched and remain poorly understood. Lubricants may also be chosen for using during sexual activities to decrease pain, increase comfort, as well as to increase a partner’s pleasure and satisfaction with sex [9,12–14]. Also, women commonly indicate that they first began using lubricant during sexual activities because of a partner’s suggestion, highlighting the role of couple interactions in sexual decision making [15]. In recent years, commercial lubricants have become more widely marketed and are commonly available in mainstream retail stores and drug stores in the United States [16,17]. Widespread emphasis on men’s condom use may also have influenced greater acceptability of lubricant use given that most condoms are prelubricated, typically with silicone lubricant. Although there is a small but growing body of literature related to women’s use of lubricant during sexual activities for sexual enhancement as well as for pain reduction [10–15], there is less research about men’s use of lubricants outside the context of sex between men and HIV risk. However, many men may use lubricant for a variety of solo and partnered sexual experiences. Men may use lubricant while they masturbate alone or with a partner, during foreplay or partnered sex play, during vaginal or anal intercourse, and—given the availability of flavored J Sex Med 2014;11:1125–1135
Reece et al. lubricant—perhaps during oral sex as well. It is important to understand more about men’s lubricant use for several reasons: (i) to learn more about men’s sexuality apart from a risk-focused model; (ii) to understand more about how men choose to modulate their sexual experiences to enhance their or their sexual partner’s arousal, comfort, and/or orgasm; and (iii) to assess how men feel about lubricant use. The latter points, in particular, may be important in understanding men’s willingness to use lubricant either to enhance their own sexual experiences or to be responsive to their sexual partner’s needs (related to pain reduction or pleasure) and desires. Aim
The purpose of these analyses, which are based on data from the 2012 National Survey of Sexual Health and Behavior (2012 NSSHB), is to document the prevalence of commercial lubricant use among adult men (age over 18 years) in the United States, to document men’s use of lubricants across solo and partnered sexual behaviors, and to assess men’s perceptions of the contributions lubricants have to the sexual experience. Methods
This article presents data from the 2012 NSSHB, a population-based cross-sectional survey of adults in the United States. Data were collected during October to November 2012 via the KnowledgePanel of GfK Custom Research (GfK) (Menlo Park, California). Research panels accessed through GfK’s KnowledgePanel are based on a national probability sample established using both random digit dialing and an addressbased sampling (ABS) frame. ABS involves the probability sampling of a frame of residential addresses in the United States derived from the U.S. Postal Service’s Delivery Sequence File, a system that contains detailed information on every mail-deliverable address in the United States. Collectively, the sampling frame from which participants are recruited covers approximately 98% of all U.S. households. Randomly selected addresses are recruited to the research panel through a series of mailings and subsequently by telephone followups to nonresponders when possible. To further correct sources of sampling and nonsampling error, study samples are corrected with a poststratification adjustment using demographic distributions from the most recent data available
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Men’s Lubricant Use from the current population survey, the monthly population survey conducted by the U.S. Bureau of the Census considered to be the standard for measuring demographic and other trends in the United States. These adjustments result in a panel base weight that was employed in a probability proportional to size selection method for establishing the samples for this study. Once the sample frame was established, all individuals within that frame received a recruitment message from GfK that provided a brief description of the NSSHB and invited them to participate. A total of 6,175 adults were included in the initial sampling frame, with 61.5% (N = 4,020) viewing the informed consent. Of those viewing the informed consent, 81.7% (N = 3,285) consented to participate, with a total of 3,138 of those individuals (95.5%) completing the survey. Of these participants, 48.1% (N = 1,510) were identified as men and are included in the current analyses. The survey was administered in either English or Spanish. All data were collected by GfK via the Internet; participants in a given GfK KnowledgePanel were provided with access to the Internet and hardware if needed. Multiple researchers have used GfK’s KnowledgePanel for multiple health-related studies, substantiating the validity of such methods for obtaining data from nationally representative samples of the U.S. population [18–24]. Main Outcome Measures
Commercial Lubricant Use Participants were asked to provide details about the extent to which they had used a lubricant. Response options included that participants had used a lubricant within the 30 days prior to participating in the study, 90 days prior to the study, within the past 12 months, more than 1 year ago, or never. Participants were provided with a definition of lubricant that included “any personal lubricant or vaginal moisturizer that you can purchase in a store marketed to enhance the sexual experience and/or increase lubrication.” Commercial Lubricant Use During Specific Sexual Behaviors and Other Product Use Participants were also asked (using the same response categories as above) to describe whether they had used a lubricant during specific sexual behaviors, including while masturbating alone,
during sexual play or foreplay with a partner, and during intercourse. Participants were also asked to respond similarly as to whether they had used a lubricant in conjunction with a condom, a vibrator, or a dildo.
Reasons for Commercial Lubricant Use Men were asked to provide the main reasons for their initial use of a lubricant, with 18 response options including “to make sex feel more wet” to “because my partner wanted to” and “to spice up my/our sex life” among others. Perceptions of Commercial Lubricant Use Participants were asked to respond to the extent to which they agreed or disagreed with items related to their perceptions of the use of lubricant during sexual activities. These items ranged from those such as “lubricant use is embarrassing” to “lubricant makes sex feel better” to “lubricant is only for older people.” Response options included a fourpoint response scale ranging from strongly disagree to strongly agree. Data Analyses During analyses, poststratification data weights were used to minimize bias because of nonsampling error. Distributions for age, race, sex, Hispanic ethnicity, education, and U.S. census region were used in poststratification adjustments. A series of bivariate logistic regressions were used to investigate the relationship between various sociodemographic characteristics (i.e., age, education, race/ethnicity, sexual orientation, relationship status) and lifetime lubricant use. Recency, frequency, perceptions, and reasons for lubricant use were explored using descriptive statistics (e.g., frequencies).
Results
Sociodemographic Characteristics As can be seen in Table 1, participants ranged in age from 18 to 89 (M = 46.13, standard deviation = 16.84). Over half reported some college or completion of college. Most participants were white, non-Hispanic with a sizable minority of participants indicating that they were black, nonHispanic (10.7%, N = 162), or Hispanic (15.2%, N = 229). Most participants were identified as heterosexual (93.6%, N = 1,384), and 53.8% (N = 806) reported living with their spouse. J Sex Med 2014;11:1125–1135
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Table 1 Participant sociodemographic distribution by lifetime lubricant use history using poststratification weights (N = 1,510) Lubricant Use
No Lubricant Use
Lubricant Use vs. No Lubricant Use
Characteristics
% (N)
%
odds ratio (95% CI)
Age 18–24 (ref) 25–29 30–39 40–49 50–59 60–69 70+
10.9 (164) 11.2 (169) 16.6 (251) 18.7 (283) 18.5 (279) 15.1 (228) 9.1 (137)
49.7 77.1 73.2 74.5 71.9 67.0 70.4
50.3 22.9 26.8 25.5 28.1 33.0 29.6
3.39**** (2.09–5.49) 2.73**** (1.78–4.19) 2.94**** (1.94–4.47) 2.56**** (1.69–3.87) 2.04**** (1.33–3.13) 2.40**** (1.48–3.92)
Education Less than high school (ref) High school or GED Some college or associates degree College degree or higher
12.5 (189) 31.4 (474) 27.3 (412) 28.8 (436)
62.5 68.6 70.1 74.6
37.5 31.4 29.9 25.4
1.31 (0.91–1.90) 1.41 (0.97–2.05) 1.76*** (1.21–2.58)
Race/ethnicity White, non-Hispanic (ref) Black, non-Hispanic Other, non-Hispanic Hispanic More than two races, non-Hispanic
67.3 (1016) 10.7 (162) 5.6 (84) 15.2 (229) 1.2 (19)
72.6 64.0 61.3 64.7 78.9
27.4 36.0 38.7 35.3 21.1
0.67* (0.46–0.96) 0.61* (0.37–0.99) 0.69* (0.50–0.94) 1.60 (0.50–5.09)
Sexual orientation Heterosexual (ref) Homosexual/gay Bisexual Asexual Other
93.6 (1384) 4.2 (63) 1.2 (17) 0.6 (9) 0.4 (6)
69.2 98.4 68.8 60.0 50.0
30.8 1.6 31.3 40.0 50.0
20.27**** (3.65–112.65) 0.86 (0.30–2.43) 0.70 (0.10–4.84) 0.57 (0.11–2.80)
Relationship status Single and not dating (ref) Single and dating In a relationship but not living together Living with relationship partner Married and living together Married but not living together
19.5 (293) 6.8 (101) 7.7 (116) 10.5 (158) 53.8 (806) 1.6 (24)
55.5 59.4 69.3 76.2 76.0 56.0
44.5 40.6 30.7 23.8 24.0 44.0
1.18 (0.74–1.87) 1.83** (1.16–2.91) 2.62**** (1.67–4.12) 2.56**** (1.92–3.40) 1.07 (0.46–2.46)
*P ≤ 0.05. **P ≤ 0.01. ***P ≤ 0.005. ****P ≤ 0.001 CI = confidence interval
Lubricant Use History Lubricant use history significantly varied based upon all sociodemographic characteristics assessed (Table 1). Relative to 18- to 24-year-olds, the odds of participants in older age cohorts reporting lifetime lubricant use were two to three times higher (P < 0.001). The odds of lubricant use were higher among college graduates (P < 0.001) and white, non-Hispanic participants (P < 0.05) than other groups. Participants who were identified as gay/ homosexual were more likely to report lubricant use than men who were identified as straight/ heterosexual (P < 0.001). Finally, those in a relationship were more likely to use lubricant than those who were single and not dating (P < 0.01). Overall, 70% (N = 1,014) of men indicated that they had used a lubricant at least once within their lifetime (Table 2). A total of 25.4% (N = 368) reported that they had used a lubricant within the past 30 days. Rates of lubricant use were the lowest J Sex Med 2014;11:1125–1135
amongst 18- to 24-year-olds, with 25% more having done so in some older age cohorts. After age 25, lubricant use rates are similar across age groups. That so many more men have used lubricant after age 25 may reflect the greater proportions of men who begin having vaginal intercourse, or more frequent vaginal intercourse, in their 20s [9]. Regarding men’s context of use, approximately half of the participants indicated that they had used lubricant during solo masturbation (49.9%, N = 717) or during partnered sexual play (54.3%, N = 782) with the highest percentage of participants indicating that they had used a lubricant during partnered intercourse (62.3%, N = 892).
Lubricant Use with Condoms,Vibrators, and Dildos Participants were also asked about their use of lubricants with condoms, vibrators, and dildos. About 41% (N = 586) of men reported using a
54.3 (782) 14.0 (201) 8.6 (124) 9.1 (131) 22.7 (326)
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Used a lubricant during partnered sexual play
Used a lubricant during partnered intercourse
Used a lubricant with a condom
Used a lubricant with a vibrator
Used a lubricant with a dildo
The bold text is to highlight the “Ever used” data.
49.9 (717) 17.3 (249) 7.2 (104) 7.7 (110) 17.7 (254)
Ever used Past 30 days Past 90 days Past 12 months (year) More than a year ago
Used a lubricant during solo masturbation
21.2 (306) 3.1 (45) 3.0 (44) 3.1 (45) 12.0 (173)
28.5 (406) 4.5 (64) 3.7 (52) 4.9 (69) 15.5 (220)
40.8 (586) 5.8 (84) 3.0 (44) 5.9 (84) 26.0 (375)
62.3 (892) 19.5 (280) 8.7 (124) 10.2 (146) 23.9 (342)
% (N) 70.0 (1014) 25.4 (368) 10.1 (147) 12.2 (176) 22.3 (323)
Ever used Past 30 days Past 90 days Past 12 months (Year) More than a year ago
Used a lubricant
Total sample
7.1 (11) 1.1 (2) 0.8 (1) 3.4 (5) 1.8 (3)
12.1 (18) 0.9 (1) 3.8 (6) 4.2 (6) 3.2 (5)
24.6 (37) 8.3 (13) 3.7 (6) 8.4 (13) 4.2 (6)
34.2 (52) 10.7 (16) 6.8 (10) 10.8 (16) 5.8 (9)
24.0 (36) 3.4 (5) 4.0 (6) 9.0 (14) 7.6 (11)
34.0 (51) 12.3 (19) 10.1 (15) 5.8 (9) 5.8 (9)
49.9 (76) 18.1 (28) 7.3 (11) 15.5 (24) 9.0 (14)
% (N)
18–24
24.0 (40) 1.5 (3) 9.0 (15) 2.2 (4) 11.3 (19)
39.2 (64) 4.0 (7) 7.4 (12) 8.7 (14) 19.1 (31)
51.2 (85) 12.0 (20) 5.7 (9) 7.7 (13) 25.9 (43)
62.6 (102) 19.4 (32) 13.2 (21) 11.7 (19) 18.3 (30)
56.0 (92) 14.7 (24) 12.4 (21) 10.4 (17) 18.4 (30)
54.7 (88) 19.4 (31) 10.2 (17) 9.1 (15) 15.9 (26)
77.2 (128) 27.7 (46) 18.0 (30) 13.2 (22) 18.3 (30)
25–29
Weighted lifetime and recency of lubricant use during various sexual contexts
Recency of lubricant use
Table 2
23.7 (57) 4.3 (10) 3.1 (7) 5.0 (12) 11.4 (27)
32.0 (74) 6.4 (15) 4.0 (9) 5.2 (12) 16.4 (38)
52.4 (125) 6.1 (14) 3.7 (9) 8.5 (20) 34.1 (82)
67.9 (160) 19.8 (47) 10.7 (25) 13.0 (31) 24.4 (58)
61.6 (148) 14.0 (34) 10.1 (24) 11.3 (27) 26.2 (63)
63.4 (152) 22.5 (54) 9.8 (24) 8.9 (21) 22.2 (53)
73.2 (175) 23.8 (57) 10.8 (26) 14.8 (35) 23.8 (57)
30–39
28.4 (77) 5.8 (16) 2.8 (8) 4.5 (12) 15.3 (41)
36.0 (98) 6.6 (18) 3.3 (9) 5.4 (15) 20.6 (56)
50.6 (137) 5.6 (15) 2.0 (5) 7.7 (21) 35.3 (96)
67.6 (183) 25.1 (68) 7.6 (20) 11.3 (30) 23.8 (64)
63.6 (173) 18.4 (50) 10.6 (29) 12.6 (34) 22.2 (60)
59.5 (162) 21.0 (57) 10.7 (29) 8.8 (24) 18.9 (51)
74.6 (204) 30.2 (83) 10.8 (30) 11.3 (31) 22.2 (61)
40–49
27.5 (73) 2.9 (8) 4.1 (11) 2.4 (6) 18.1 (48)
31.7 (83) 5.6 (15) 3.3 (9) 4.6 (12) 18.1 (48)
37.3 (99) 5.6 (15) 4.0 (11) 4.4 (12) 23.2 (62)
65.7 (175) 23.3 (62) 10.3 (27) 8.6 (23) 23.6 (63)
60.8 (161) 15.0 (40) 12.1 (32) 8.2 (22) 25.4 (67)
48.1 (128) 18.0 (48) 4.5 (12) 6.4 (17) 19.3 (51)
71.8 (192) 30.5 (81) 12.1 (32) 8.1 (22) 21.1 (56)
50–59
16.8 (37) 1.4 (3) 0.2 (1) 2.7 (6) 12.6 (27)
24.7 (52) 3.9 (8) 2.3 (5) 3.2 (7) 15.3 (32)
30.1 (64) 1.9 (4) 1.6 (3) 2.6 (6) 24.0 (51)
64.1 (138) 18.7 (40) 6.5 (14) 8.5 (18) 30.4 (65)
50.1 (106) 15.5 (33) 4.0 (9) 7.5 (16) 23.0 (49)
45.2 (96) 14.6 (31) 1.9 (4) 9.3 (20) 19.4 (41)
67.1 (144) 24.6 (53) 5.6 (12) 13.8 (30) 23.0 (49)
60–69
5.9 (8)
5.9 (8) 2.6 (3) 0.9 (1)
12.2 (16) 0.4 (1) 1.9 (3) 2.1 (3) 7.8 (10)
29.1 (38) 1.9 (3) 0.4 (1) 0.2 (0) 26.5 (35)
63.1 (83) 11.5 (15) 4.2 (5) 6.6 (9) 40.8 (54)
48.7 (66) 11.4 (15) 2.6 (3) 1.2 (2) 33.5 (45)
29.8 (40) 6.9 (9) 2.3 (3) 3.5 (5) 17.1 (23)
70.6 (95) 15.3 (21) 4.4 (6) 9.4 (13) 41.5 (56)
70+
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lubricant with a condom with the greatest proportion reporting that their most recent use was over a year ago. Of those who used lubricant with a condom, most indicated that they applied the lubricant to the outside of the condom (81.6%, N = 172) or on the inside and outside of the condom (11.6%, N = 24). A sizable minority of participants reported using a lubricant with a vibrator (28.5%, N = 406) or dildo (21.2%, N = 306).
cant during sexual activities “makes sex more comfortable” (85.2%, N = 828). More than two-thirds also agreed with the statements that lubricant “makes it easier to feel aroused” (69.4%, N = 686) and “makes sex feel better” (77.1%, N = 757), and more than half agreed that it “makes it easier to have an orgasm” (56.1%, N = 551). In contrast, only 10% (N = 96) of men agreed that lubricant “is only for older people.”
Lubricant Use Frequency As described in Table 3, participants who reported using a lubricant within the past 90 days were asked about their frequency of lubricant use within that time period. Generally, participants were most likely to report that they used a lubricant in these specific situations “once or twice” or “more than 10 times.” These were also the most frequently endorsed response categories for participants reporting lubricant use for each of the three sexual behaviors (e.g., during solo masturbation) and lubricant use with a condom. However, when asked about lubricant use with a vibrator or dildo, the most commonly endorsed category included “once or twice” followed by “three to five times.” These trends remained fairly consistent across age groups.
Discussion
Reasons for Lubricant Use When participants with a lubricant use history were asked to indicate their reasons for first starting to use a lubricant, the most frequently endorsed item was “to make sex more comfortable” (39.2%, N = 398), followed by “for fun” (36.1%,N = 366), “curiosity” (33.5%, N = 340), and “my partner wanted to” (26.4%, N = 268) (Table 4). For men between the ages of 18 and 49, the most common reasons were “for fun” and “curiosity.” When asked about their reasons for first starting to use lubricants during sexual activities, the most common reasons included “my partner suggested we use a lubricant,” “I wanted to make sex more pleasurable,” and “I wanted to reduce discomfort or pain during sex.” These responses were consistently the most frequently endorsed across age groups. Perceptions of Lubricant Use Participants were asked to indicate agreement with several items regarding their experiences with lubricants (see Table 5). Most men who had used a lubricant agreed with this statement: using lubriJ Sex Med 2014;11:1125–1135
In a nationally representative probability sample of men ages 18 years and older in the United States— the 2012 NSSHB—it was found that most men have used lubricant, lubricant use is prevalent across age cohorts, and men largely use lubricant during sexual activities for reasons related to sexual enhancement, comfort, and pleasure. These data underscore the widespread use of lubricants as sexual enhancement products among men and their sexual partners. Critically, these data also point to the need for scientific knowledge about pleasure and enjoyment aspects of sexuality as an aspect of sexual health not to be lost—or omitted—under the umbrella of public health research. A reading of past research related to lubricant use might lead one to believe that the role of lubricant in men’s sexual lives was predominantly related to risk reduction (e.g., to reduce friction and tearing during anal sex and/or to reduce the risk of condom breakage when two men have anal intercourse). Although the role of lubricant in HIV risk reduction is important to understand from a public health perspective, it does not do justice to the broad range of men’s sexualities and sexual experiences to view their sexual behaviors and perspectives exclusively through a risk-focused lens. Findings from this study paint a more nuanced, and a more interesting, picture of men’s sexual experiences. Men most commonly report using lubricant to make sex more comfortable and often at the suggestion of a partner. This attentiveness that men report to sexual comfort and pleasure is worth noting as it suggests a sense of proactive caring and/or responsiveness to their partners’ suggestions or needs that often go unacknowledged. Indeed, men commonly indicated that they used lubricant to enhance foreplay, to spice up their sex life, and/or to manage vaginal pain or reduce the risk of (vaginal or anal) tearing—all of which suggest an attentiveness to the realities of pleasurable and difficult aspects of sexual
11.0 (56) 26.9 (137) 21.2 (108) 13.2 (67) 27.7 (141)
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Not at all Once or twice 3–5 times 6–10 times More than 10 times
Used a lubricant
Used a lubricant during solo masturbation
Used a lubricant during partnered sexual play
Used a lubricant during partnered intercourse
Used a lubricant with a condom
Used a lubricant with a vibrator
Used a lubricant with a dildo
12.9 (11) 43.6 (38) 20.3 (18) 10.3 (9) 12.9 (11)
5.8 (7) 38.7 (45) 25.2 (29) 12.5 (14) 17.9 (21)
10.4 (13) 32.7 (41) 18.6 (23) 15.0 (19) 23.3 (29)
1.9 (8) 29.5 (119) 21.5 (87) 16.3 (66) 30.8 (124)
6.7 (22) 33.0 (107) 21.3 (69) 14.2 (46) 24.9 (81)
4.8 (17) 35.8 (125) 19.8 (69) 14.7 (51) 24.8 (86)
% (N)
Total sample
56.6 (2)
43.4 (1)
6.4 (1) 63.0 (4) 30.6 (2)
12.4 (2) 41.8 (8) 5.5 (1) 23.0 (4) 17.4 (3)
53.7 (14) 13.5 (4) 13.8 (4) 19.0 (5)
44.8 (5) 15.1 (2) 12.4 (1) 10.1 (1) 17.6 (2)
9.3 (3) 27.8 (9) 27.9 (9) 26.5 (9) 8.4 (3)
7.5 (3) 31.9 (12) 33.1 (13) 10.8 (4) 16.8 (7)
% (N)
18–24
57.6 (10) 20.6 (4) 13.0 (2) 8.9 (2)
20.4 (4) 27.6 (5) 16.5 (3) 26.6 (5) 8.8 (2)
14.4 (4) 35.3 (10) 22.6 (7) 16.3 (5) 11.4 (3)
19.8 (11) 27.3 (14) 25.0 (13) 27.8 (15)
2.1 (1) 29.8 (13) 16.8 (8) 22.6 (10) 28.8 (13)
6.8 (3) 35.8 (17) 30.9 (15) 2.2 (1) 24.3 (12)
11.2 (8) 23.8 (17) 22.4 (16) 11.6 (8) 30.9 (22)
25–29
11.0 (2) 51.7 (9) 24.2 (4) 2.3 (1) 10.8 (2)
6.9 (2) 32.0 (8) 38.8 (9) 1.7 () 20.6 (5)
14.1 (3) 16.4 (4) 22.9 (5) 15.2 (3) 31.5 (7)
0.2 (1) 41.3 (30) 17.2 (12) 14.6 (11) 26.7 (19)
5.0 (3) 44.0 (25) 17.0 (10) 12.5 (7) 21.5 (12)
5.2 (4) 39.6 (30) 9.2 (7) 20.9 (16) 25.1 (19)
9.4 (8) 30.1 (25) 20.1 (17) 11.1 (9) 29.3 (24)
30–39
19.9 (4) 33.9 (7) 18.1 (4) 8.5 (2) 19.6 (4)
2.1 (1) 25.3 (7) 35.0 (9) 9.0 (2) 28.6 (8)
3.7 (1) 33.9 (7) 20.9 (4) 3.8 (1) 37.8 (7)
2.5 (2) 27.4 (24) 19.5 (17) 12.2 (11) 38.5 (34)
6.1 (5) 26.5 (21) 21.6 (17) 15.5 (12) 30.4 (24)
5.5 (5) 29.9 (25) 22.2 (19) 17.0 (14) 25.5 (22)
8.9 (10) 26.4 (29) 20.6 (23) 13.4 (15) 30.8 (34)
40–49
12.7 (2) 52.5 (10) 14.7 (3) 6.3 (1) 13.7 (3)
59.4 (14) 21.2 (5) 5.5 (1) 14.0 (3)
1.9 (1) 45.1 (12) 12.9 (3) 17.7 (5) 22.4 (6)
2.5 (2) 27.8 (25) 22.7 (20) 13.1 (12) 33.9 (30)
7.0 (5) 49.4 (36) 19.2 (14) 4.3 (3) 20.1 (14)
1.4 (1) 42.0 (25) 13.1 (8) 10.3 (6) 33.3 (20)
11.9 (14) 31.9 (36) 19.5 (22) 11.1 (13) 25.6 (29)
50–59
Weighted frequency of lubricant used for participants who reported lubricant use in the following contexts within the past 90 days
Recency of lubricant use
Table 3
9.2 (1) 18.1 (1) 48.1 (2) 24.6 (1)
1.5 (1) 43.2 (6) 2.4 (1) 31.8 (4) 21.1 (3)
22.9 (2) 15.5 (1) 22.5 (2) 3.8 (1) 35.5 (3)
4.4 (2) 25.4 (14) 16.9 (9) 21.4 (12) 31.9 (17)
3.9 (2) 24.4 (10) 23.2 (10) 20.9 (9) 27.7 (11)
1.5 (1) 37.3 (13) 19.6 (7) 11.1 (4) 30.6 (11)
18.2 (11) 21.9 (14) 12.4 (8) 20.8 (13) 26.8 (17)
60–69
26.7 (1) 22.0 (1) 18.0 (1) 33.3 (2)
41.0 (1) 18.1 (1)
40.9 (1)
50.4 (2) 30.8 (1)
18.8 (1)
3.7 (1) 9.0 (2) 47.2 (10) 20.5 (4) 19.6 (4)
7.2 (1) 1.6 (1) 52.7 (10) 18.9 (4) 19.6 (4)
3.9 (1) 41.5 (5) 37.8 (5) 10.5 (1) 6.4 (1)
8.7 (2) 10.4 (3) 34.9 (9) 17.2 (5) 28.9 (8)
70+
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J Sex Med 2014;11:1125–1135 40.9 (31) 4.8 (4) 6.4 (5) 1.5 (1) 8.8 (7) 8.2 (6) 1.9 (1) 31.5 (24) 8.9 (7) 2.8 (2)
3.7 (37) 0.9 (9) 32.8 (332) 24.9 (252) 5.2 (53)
36.5 (28) 14.4 (11) 34.1 (26) 31.3 (24) 9.3 (7) 4.3 (3) 3.5 (3) 0.0 (0) 0.0 (0) 0.0 (0) 22.4 (17) 0.6 (0) 8.2 (6) 11.4 (9) 6.6 (5) 11.5 (9) 19.7 (15) 6.2 (5)
% (N)
18–24
48.1 (488) 8.9 (91) 10.6 (108) 2.1 (22) 1.4 (15)
36.1 (366) 22.6 (229) 33.5 (340) 26.4 (268) 13.6 (138) 3.3 (33) 2.7 (28) 0.9 (9) 0.7 (7) 4.9 (50) 39.2 (398) 8.1 (82) 11.9 (121) 15.2 (154) 3.9 (40) 22.6 (229) 21.2 (215) 3.7 (37)
Reason for first starting use For fun To enhance foreplay Curiosity My partner wanted us to To spice up my/our sex life A friend said it was fun to use My (or my partner’s) body changed during pregnancy While postpartum/nursing Because of medication use/surgery Approaching menopause To make sex more comfortable To reduce the risk of tearing To manage vaginal pain To comfortably have anal sex To reduce the risk of condom breakage To add pleasurable sensations to sex To make sex feel more wet Other
Reason for first starting use during sexual activities My partner suggested we use a lubricant I saw an advertisement for a lubricant I noticed that lubricated condoms felt more comfortable A doctor or nurse recommended a lubricant A health educator or sex educator recommended a lubricant A friend recommended a lubricant A family member recommended a lubricant I wanted to make sex more pleasurable I wanted to reduce discomfort or pain during sex Other
% (N)
Total sample
Reasons for lubricant use by age using poststratification weights
Reason for use
Table 4
5.9 (8) 1.0 (1) 21.9 (28) 21.2 (27) 4.8 (6)
50.8 (65) 8.9 (11) 14.2 (18) 0.7 (1) 0.0 (0)
39.6 (51) 23.8 (30) 43.2 (55) 25.3 (32) 16.5 (21) 2.1 (3) 0.2 (1) 0.0 (0) 0.0 (0) 0.8 (1) 31.5 (40) 13.1 (17) 10.2 (13) 10.9 (14) 3.0 (4) 18.9 (24) 26.2 (33) 1.8 (2)
25–29
3.1 (5) 1.9 (3) 32.4 (57) 20.7 (36) 4.6 (8)
45.1 (79) 7.0 (12) 14.3 (25) 2.0 (4) 0.2 (1)
48.6 (85) 20.3 (36) 38.5 (68) 23.6 (41) 10.7 (19) 3.6 (6) 2.9 (5) 1.9 (3) 0.6 (1) 0.0 (0) 28.0 (49) 8.7 (15) 8.8 (15) 14.1 (25) 4.8 (8) 20.6 (36) 21.7 (38) 3.8 (7)
30–39
5.5 (11) 0.2 (1) 33.4 (68) 23.5 (48) 3.9 (8)
56.8 (116) 11.1 (23) 11.8 (24) 0.6 (1) 2.9 (6)
40.3 (82) 28.9 (59) 40.4 (83) 29.3 (60) 16.0 (33) 6.8 (14) 3.1 (6) 1.2 (2) 0.1 (1) 2.3 (5) 36.5 (75) 10.1 (21) 11.4 (23) 18.6 (38) 4.0 (8) 26.5 (54) 21.8 (45) 3.4 (7)
40–49
2.3 (4) 0.5 (1) 36.8 (71) 34.2 (66) 6.5 (13)
44.7 (86) 9.3 (18) 9.5 (18) 1.1 (2) 0.1 (1)
29.5 (57) 23.3 (45) 22.9 (44) 26.3 (51) 12.3 (24) 2.5 (5) 1.8 (3) 1.2 (2) 0.1 (1) 7.5 (14) 49.8 (95) 6.8 (13) 9.5 (18) 21.7 (42) 3.4 (7) 22.3 (43) 18.8 (36) 4.9 (9)
50–59
1.3 (2) 1.0 (1) 37.0 (53) 28.7 (41) 9.7 (14)
43.7 (63) 10.7 (15) 9.4 (14) 4.0 (6) 0.2 (1)
31.0 (45) 23.0 (33) 29.1 (42) 22.3 (32) 18.0 (26) 1.4 (2) 2.1 (3) 0.6 (1) 0.0 () 15.2 (22) 49.2 (71) 6.3 (9) 17.0 (25) 14.5 (21) 3.5 (5) 26.6 (38) 21.9 (31) 4.3 (6)
60–69
0.8 (1) 0.6 (1) 33.1 (31) 28.7 (27) 1.9 (2)
50.8 (48) 7.6 (7) 3.9 (4) 7.2 (7) 1.2 (1)
20.2 (19) 16.3 (15) 23.8 (23) 29.1 (28) 9.7 (9) 0.0 (0) 7.5 (7) 0.0 (0) 5.9 (6) 8.0 (8) 53.5 (51) 6.9 (7) 21.6 (20) 6.2 (6) 2.6 (2) 26.3 (25) 17.6 (17) 1.2 (1)
70+
1132 Reece et al.
1133
54.8 70 50.2 64 54.3 69 17.8 22 69.4 83 45.2 58 49.8 63 45.7 58 82.2 103 30.6 37 62.3 127 50.2 101 70.3 142 16.1 32 78.5 154 37.7 77 49.8 100 29.7 60 83.9 168 21.5 42 56.3 143 47.9 120 64.2 162 10.2 25 73.6 184 43.7 111 52.1 131 35.8 90 89.8 220 26.4 66 67.1 180 54.8 147 68.8 184 11.9 32 76.3 203 32.9 88 45.2 121 31.2 84 88.1 234 23.7 63 58.8 133 51.4 116 67.3 152 14.4 31 73.1 164 41.2 93 48.6 110 32.7 74 85.6 187 26.9 61 57.8 95 40.7 66 66.3 106 13.8 22 66.6 109 42.2 69 59.3 96 33.7 54 86.2 137 33.4 55 73.3 102 58.1 81 66.8 92 28.1 37 70.3 98 26.7 37 41.9 58 33.2 46 71.9 96 29.7 41 61.5 850 50.5 695 66.1 908 15.0 202 73.2 995 Makes
Is only
Makes
Makes
% 38.5 N 533 it easier to have an orgasm % 49.5 N 680 sex feel better % 33.9 N 465 for older people % 85.0 N 1,146 sex more comfortable % 26.8 N 364 Makes it easier to feel aroused
Disagree Agree Disagree Agree Disagree Agree Disagree Agree Disagree Agree Disagree Agree Disagree Agree Disagree Agree
25–29 18–24 Total
Using lubricant during sexual activities
Table 5
Perceptions of lubricant use by age using poststratification weights
30–39
40–49
50–59
60–69
70+
Men’s Lubricant Use
experience, and a desire to create sexual experiences with a partner who feels mutually pleasurable and satisfying. Although women’s roles in sexual enhancement have often been noted, men’s involvement in sexual pleasure enhancement has perhaps less often been highlighted. These data suggest that men, like women, take active roles in creating pleasurable sexual lives. Men also reported using a lubricant in a variety of contexts including solo masturbation, partnered sex play, intercourse, and in association with the use of condoms, vibrators, and dildos. Although much of the paired product use (i.e., lubricant with condom, lubricant with vibrator or dildo) occurred more than a year ago—perhaps suggesting that condoms, vibrators, or dildos themselves have not been used as recently—nearly one in five men reported using a lubricant during solo masturbation in the past 30 days. Similarly, one in five men reported using a lubricant during intercourse in the past 30 days. This study had several strengths and limitations. A significant strength is that sexual behavior and lubricant use were assessed in a nationally representative probability sample of American men ages 18 and older. Participants were able to complete the survey via the Internet, thus facilitating privacy and ease of access. Men were eligible to be part of the GfK’s KnowledgePanel—and thus part of the study—regardless of their personal financial or technological resources. That is, if they lacked Internet access or the hardware or software necessary to complete Internet-based surveys for the panel, they were provided with the needed resources as part of GfK membership. Participants were also already familiar with completing GfK surveys and thus did not require additional training regarding survey completion. A limitation is that the sample was restricted to individuals who had a home address and who were community dwelling (e.g., not institutionalized or homeless). This may have limited the sample, particularly for much older individuals and/or those experiencing health conditions that warrant inpatient care. Some men may not have felt comfortable answering questions about their sexual or lubricant use behaviors or may not have understood the questions (and because the survey was administered online, they would not have been able to ask for clarification). Also, it may be that participants who agreed to participate in a survey about sexual behavior or lubricant use have different experiences or attitudes about sexuality or lubricants compared with individuals who chose J Sex Med 2014;11:1125–1135
1134 not to participate in the research. Additionally, this study included only individuals—not couples— and subsequent research may benefit from including partners’ perspectives. Subsequent research might also be attentive to recent and event-level lubricant use, providing insights into how lubricants are used for specific sexual activities within context. Finally, although we defined what we meant by a “lubricant” at various points throughout the survey, it is possible that some participants had different definitions in mind. However, we expect that this number would be small enough so as not to have a significant influence on our findings. As sexual enhancement products become more widely available and marketed, research needs to be attentive to potential changes in men’s and women’s sexual lives with increasing integration of such products into sexual activities. The diverse ways in which lubricants are used by men indicate that lubricants are likely to be applied to a variety of body sites and may enter various orifices including the mouth, anus/rectum, urethra, and vagina. Clinicians practicing in a variety of specialties (e.g., dermatology, urology, sexual medicine, internal medicine, gynecology) need to know how and where men and their sexual partners apply lubricants or how they otherwise use sexual enhancement products (including condoms, vibrators, and dildos) as part of their solo and partnered sexual experiences. A greater knowledge base of human sexual behavior and consumer product use may provide insights into patients’ sexual health—for example, the extent to which patients are using lubricants to address a problem (such as their own or a partner’s genital pain or discomfort during sex) or to enhance an already pleasurable sex life. Clinicians might consider, too, the extent to which they might suggest lubricant use as a means of sexual enhancement for patients who inquire about ways to enhance their own arousal, ease of orgasm, comfort, or pleasure during sex. Finally, these data provide additional insights into the broader experience of male sexuality. Too often, men’s sexual experiences are couched in risk (e.g., HIV/AIDS risk and associated risk reduction strategies), danger (e.g., sexual assault and rape), or dysfunction (e.g., erectile dysfunction), with little attention given to collecting data and creating evidence-based communications about the diverse ways men experience their sexual lives. These data complement findings from a parallel study of women’s use of lubricant [24], which demonstrate that pleasure, enhancement, and sexual comfort/ J Sex Med 2014;11:1125–1135
Reece et al. pain reduction are important reasons that both sexes first use lubricants. Such characteristics appear to be of value to many men as well as to many women, highlighting the efforts that both sexes make to please each other while at the same time pleasing oneself through sexual expression. Conclusions
Findings from the 2012 NSSHB demonstrate that most American men have used a lubricant, that lubricant use is common across all age groups, and that some of the most common reasons why men report using lubricant have to do with sexual enhancement, comfort, and pleasure. Clinicians may find these data helpful to their efforts to educate patients about lubricant use, comfort during sex, and sexual enhancement. Acknowledgments
This study was partially funded by Church & Dwight, Co., Inc. Corresponding Author: Debby Herbenick, PhD, MPH, Center for Sexual Health Promotion, Indiana University, Bloomington, IN 47405, USA. Tel: 812855-0364; Fax: 812-855-3936; E-mail: debby@ indiana.edu Conflict of Interest: Michael Reece is a member of the sexual health advisory council of Church & Dwight Co., Inc. Statement of Authorship
Category 1 (a) Conception and Design Michael Reece; Debby Herbenick; Vanessa Schick; Stephanie A. Sanders; J. Dennis Fortenberry (b) Acquisition of Data Michael Reece; Debby Herbenick; Vanessa Schick; Stephanie A. Sanders; J. Dennis Fortenberry (c) Analysis and Interpretation of Data Vanessa Schick; Debby Herbenick
Category 2 (a) Drafting the Article Debby Herbenick; Michael Reece; Vanessa Schick (b) Revising It for Intellectual Content Michael Reece; Debby Herbenick; Vanessa Schick; Stephanie A. Sanders; J. Dennis Fortenberry
Category 3 (a) Final Approval of the Completed Article Michael Reece; Debby Herbenick; Vanessa Schick; Stephanie A. Sanders; J. Dennis Fortenberry
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J Sex Med 2014;11:1125–1135
